Urine screening for early detection of subarachnoid neurocysticercosis

项目总结 神经囊虫病(NCC)是一种常见的神经系统疾病，也是可预防癫痫的主要原因。 发展中世界。它是由猪带绦虫幼虫感染中枢神经系统引起的。 囊肿症。虽然大多数NCC病例的临床病程相对良性，但感染的预后是严峻的。 涉及蛛网膜下腔(SANCC)。需要新的方法来改善患者的预后 这种毁灭性的恶性感染形式。一个有希望的方法是通过以下方式及早发现 人口筛查，这将允许在感染负担较低的情况下进行早期干预，同时 患者身体状况相对较好。我们最近开发了一种检测沙门氏菌排泄抗原的方法 在尿液中，现在已经在试点研究中表明这种检测方法可以用来检测没有症状的人 在社区环境中使用SANCC。 在这个为期5年的项目中，我们将通过在北部地区的一项大型横断面研究中应用新的检测方法来验证新的检测方法。 秘鲁(30,000)，使用脑部磁共振成像(MRI)作为确认诊断的金标准。 随后被诊断为无症状SANCC的参与者将参加为期18个月的 确定疾病进展风险的前瞻性观察队列，或小型临床试验评估 早期干预对无症状SANCC的安全性。此外，我们将开发一个原型的护理点 测试的格式，并用从社区收集的样本进行验证。这些研究的结果将 提供必要的信息和工具，以进行明确的随机临床试验，评估疗效 筛查和早期干预是改善SANCC患者临床预后的一种方法。我们 还将提供一系列讲授和动手的实验室和临床研究培训机会 来自秘鲁北部地区的学生。

PROJECT SUMMARY Neurocysticercosis (NCC) is a common neurologic disease and a leading cause of preventable epilepsy across the developing world. It is caused by central nervous infection with Taenia solium (the pork tapeworm) larval cysts. While most cases of NCC have a relatively benign clinical course, the prognosis is grim for infections involving the subarachnoid space (SANCC). New approaches are needed to improve outcomes for patients with this devastating malignant form of infection. One promising approach involves early detection through population screening, which would allow early intervention while the burden of infection is low and while the patient retains relatively good health. We recently developed an assay that detects T. solium antigens excreted in the urine, and have now shown in pilot studies that this assay can be used to detect asymptomatic people with SANCC in the community setting. In this 5-year project we will validate the new assay by applying it in a large cross-sectional study in northern Peru (30,000), using magnetic resonance imaging (MRI) of the brain as the gold standard to confirm diagnosis. Participants subsequently diagnosed with asymptomatic SANCC will be enrolled in either an 18-month prospective observational cohort to determine risk of disease progression, or a small clinical trial evaluating safety of early intervention for asymptomatic SANCC. Furthermore, we will develop a prototype point-of-care format of the assay and validate it with samples gathered from the community. The results of these studies will provide information and tools necessary to conduct a definitive randomized clinical trial evaluating the efficacy of screening and early intervention as an approach to improve clinical outcomes of patients with SANCC. We will also provide a series of didactic and hands-on laboratory and clinical research training opportunities for students from northern regions of Peru.